Patients suffering from schizophrenia, schizoaffective and schizophreniform disorder diagnosed by a structured interview by DSM III-R criteria who are between the ages of 18 and 55 and are free of significant medical illnesses and have close contact with their family of origin, are being recruited for the study from an emergency psychiatric clinic and inpatient service of a large county hospital in a metropolitan area. The study is a multi-center collaborative ongoing project, using a double-blind design, to look at different drug maintenance strategies (standard, low and intermittent dosages of fluphenazine decanoate) and their relationship to psychosocial management strategies (applied and supportive family therapy). Patients will be involved in the study for a period of up to two and a half years each, with psychosocial intervention lasting for one year. The project is being carried out by a research team which provides intensiv out-patient care. Symptom exacerbations are being dealt with by increasing the frequency of the contact, increasing blind medications, adding open medications and/or hospitalization under research staff supervision. Famil Management Clinicians are providing supportive (monthly group meetings) or applied (specified frequency of contact through home visits) family treatment. Data collected is being transmitted to NIMH where it is managed pooled with data from other collaborating centers, and analyzed. It is hypothesized that there will be a linear effect of drug treatment suc that patients on standard dose of medication will experience fewer episodes of symptom exacerbation, but will have more side effects and negative symptoms. Patients in the applied family management group will also have fewer episodes of symptom exacerbation. Patients who fail to stabilize within 24 weeks of their index hospitalization and those who need more than 140 days of "open" medication within a 12-month period, are being recruited into an 8 week placebo controlled trial of lithium augmentation. The cost effectiveness of the various treatments in the study are also being evaluated.